The objective of this project is to facilitate the delivery of dental care to children handicapped by cerebral palsy. The constant, uncontrolled head movements typical of these children necessitate the use of general anesthesia in current practice to obtain safe, reliable access to the oral cavity. Our intent is to eliminate the "involuntary" head movements through development of a device which will stabilize the patient's head in any position desired by the dentist or hygienist. Development of the Head Stabilizer will be a multidisciplinary project involving biomedical sciences and engineering. The design of the device is such that the operator selects the desired head position using a joystick manipulator. Any time the desired and actual positions tend to differ, the resulting error signal leads to actuation of pneumatic cylinders which apply counteracting forces sufficient to return the head to the initially set point. The Stabilizer first will be tested with CP children to determine its efficacy and the time required for the children to become accustomed to it. Quantitative studies of head position under the influence of the Stabilizer will be carried out, and the effectiveness of the device will also be documented using cinematography. Next, dental procedures will be simulated to determine if the device can maintain head position despite these procedures. Dental hygienists, dental students and participating dental faculty will provide input regarding design optimization and development of accessories. Finally, the Stabilizer will be tested during actual dental procedures. Also, longer term studies will be done to determine if it can be used to train CP children for improved voluntary head control through automatic provision of resistive exercise. After design optimization of the device, a CP dental care facility will be set up within the University of Washington School of Dentistry, where UW students and community dentists will be trained in the use of the device. An existing device which can be used to train CP children to brush their teeth will also be incorporated into the program to provide for dental maintenance.